October is Breast Cancer Awareness Month

Breast cancer is the most commonly diagnosed cancer among American women. To learn more about breast cancer screening at VA, download our SERVICE Act handout or call 1-855-VA-WOMEN for more information.

Although no direct link has been found between military service and breast cancer, we continue to study the effects your service may have on your health. 

The SERVICE Act requires VA to ensure that any Veteran who was deployed during active military, naval, or air service, to an identified area where they may have had a toxic exposure (such as burn pits) is eligible for a breast cancer risk assessment by a VA health care provider and a clinically appropriate mammogram either within the VA or in the community.

So what do you need to know? 

• One in eight women will be diagnosed with breast cancer in their lifetime. 
  • The risk of breast cancer increases with age.
  • Breast cancer is the most common cancer and second most common cause of cancer deaths in American women.
  • Black women are more likely to die from breast cancer than other races/ethnicities.
• VA exceeds the private sector in mammography screening rates. The benefits of mammography are greater for older women than younger women; however, every Veteran identified by the SERVICE Act, regardless of age, is eligible for a cancer risk assessment and a mammogram, if it is determined to be clinically appropriate based on the risk assessment, regardless of whether you are enrolled in VA health care.
  • Mammograms can find breast cancer early, and the earlier a cancer is found, the easier it is to treat.
• Both the American Cancer Society and VA no longer recommend routine breast exams, which is where your doctor will physically examine your breasts for lumps and changes. However, you should always tell your VA healthcare team about any changes you notice in your breasts.
• While no direct link has been found between deployment and breast cancer, VA is concerned about individual reports and is continuing studies to determine if toxic exposure may be a cause of breast cancer. 
• The SERVICE Act guarantees that any Veteran who served in designated combat locations during specific periods will receive breast cancer risk assessments and undergo a mammogram if it is determined to be clinically appropriate based on the risk assessment, regardless of VA health care enrollment status. Specific locations and periods include: 
  • Iraq between August 2, 1990, and February 28, 1991, and from March 19, 2003, until burn pits (areas of land used for the open-air combustion of trash and other solid waste products) are no longer used;
  • The Southwest Asia theater of operations, including Kuwait, Saudi Arabia, Oman, and Qatar, from August 2, 1990, until burn pits are no longer used in such locations; and
  • Afghanistan, Djibouti, Syria, Jordan, Egypt, Lebanon, and Yemen from September 11, 2001, until burn pits are no longer used in such locations.
• VA recommends the following breast cancer screening guidance (in line with the SERVICE Act and American Cancer Society guidelines):
  • Age 30 or younger – VA does not recommend mammograms because they are not generally useful at this age, particularly if you have no other risk factors.
    • If you are younger than 30 and at high risk, VA will recommend a more detailed assessment that may include genetic testing or other breast imaging (i.e., a magnetic resonance imaging, or MRI).
  • Age 30-39 – Speak with your doctor to assess your risk and determine whether you should begin annual mammogram screening.
  • Age 40-44 – Begin annual screening, if decided with your doctor.
  • Age 45-54 – Screen yearly.
  • Age 55 or older – Screen every other year or continue yearly screening.
• You have access to breast cancer support and resources through VA, including:
  • Mammography on-site at over 70 VA facilities and community facilities
  • Breast ultrasounds and MRI
  • Breast biopsy and surgery
  • Genetic counseling and testing
  • Cancer diagnosis and treatment
• If you’re diagnosed with breast cancer, you have access to comprehensive oncology services and treatments that include imaging, surgery, chemotherapy, radiation, and other advanced state-of-the-art therapies as needed, either on-site or via community referrals. You’re also eligible for enrollment into clinical trials.
• Every VA facility has a Women Veterans Program Manager and Women's Health Primary Care Providers to ensure you have access to appropriate care and treatment. They will connect you with their clinical teams to coordinate all the services you may need.

For information on how to get scheduled for your Mammogram contact:

Your Women Veterans Program Manager is Bonnie Owen, M.S., PA-C, 740-773-1141, x16062

Your Mammogram Coordinator is Lori Rapp, RN, 740-773-1141, x16485

Your Primary Care PACT teams can order your mammogram as well. 

• Contact your VA Women’s Health Primary Care Provider team if you have questions or concerns about your breast cancer risk and to determine if a mammogram is right for you.
• VA provides state-of-the-art, coordinated breast cancer care, including 
  mammograms, breast Ultrasound and MRI, genetic counseling and testing, cancer diagnosis and treatment and more.
• If you are worried about job exposures impacting your breast cancer risk, connect with your VA primary care provider team to discuss your concerns.
• For women ages 45 and older, VA recommends regular breast cancer screening. Women may also choose to start screening with yearly mammograms as early as age 40. Talk with your VA primary care provider team about scheduling your mammogram.
• Don’t wait another year to get checked if you missed your mammogram due to COVID-19. Talk with your VA primary care provider team about scheduling your mammogram.
• Localized breast cancer has a 99% survival rate if detected early. Talk with your VA primary care provider team about scheduling your mammogram.
• Five to 10 percent of breast cancer is hereditary. If there’s a history of breast cancer in your family, talk with your VA provider team to understand your risks and when you should start receiving mammograms.
• Obesity and alcohol consumption are both risk factors for breast cancer. Connect with your VA primary care provider team to get checked and to better understand your risk.
• Women Veterans who receive care through VA are much more likely to receive age-appropriate breast cancer screenings than women in private-sector health care. 

Q&A 

The following points may be used in any capacity when communicating with Veterans at VA and for answering frequently asked questions. 

Q1. Am I eligible for breast cancer screening at VA? 

A1. The Dr. Kate Hendricks Thomas Supporting Expanded Review for Veterans in Combat Environment (SERVICE) Act allows Veterans who served in specified combat locations during certain periods to receive breast cancer risk assessments and get a mammogram, if it is determined to be clinically appropriate based on the risk assessment, regardless of whether you are enrolled in VA health care or not. Learn more about the SERVICE Act to see if you served in an eligible location and period. 

Enrolled Veterans: If you do not have a primary care provider, you may contact your local VA facility to schedule a breast cancer risk assessment appointment with the SERVICE Act point of contact (POC) provider.  

Unenrolled Veterans: Apply for VA health care benefits. If you are not eligible or do not desire enrollment, you will be directed to register only. After enrollment or registration, you may contact your local VA facility to schedule an appointment with the SERVICE Act POC provider. 

Regardless of your service history, we recommend you speak with your VA health care provider about your risk for breast cancer. VA recommends the following breast cancer screening guidance (in line with the SERVICE Act and American Cancer Society guidelines):

• Age 30 or younger – VA does not recommend mammograms because they are not generally useful at this age, particularly if you have no other risk factors. 
  • If you are younger than 30 and at high risk, VA will recommend a more detailed assessment that may include genetic testing or other breast imaging (i.e., MRI).
• Age 30-39 – Speak with your doctor to assess your risk and determine whether you should begin annual mammogram screening. 
• Age 40-44 – Begin annual screening, if decided with your doctor. 
• Age 45-54 – Screen yearly.
• Age 55 or older – Screen every other year or continue yearly screening.

Note that routine breast exams (a physical exam where your doctor will examine your breasts for lumps and changes) are no longer recommended for breast cancer screening at any age, but you should report any breast changes you notice. If you have breast symptoms such as a lump, skin changes, pain, or nipple discharge, please speak with your VA health care team as soon as possible.

Q2. Am I at risk for breast cancer? How do I reduce my risk?

A2. Common risk factors include your age, race, weight, and use of alcohol. Other risk factors are related to your family medical history and your personal medical history, such as age of puberty, age of first pregnancy or history of pregnancy loss, use of certain medications, history of chest radiation, and breast characteristics (e.g., how dense your breasts are and whether you have had a breast biopsy or breast cancer before).

Toxic exposure such as burn pits could be a risk factor, but research to date has not shown that deployment increases your risk. VA is continuing its research and your VA health care team will help you assess your risk.

To reduce your risk for breast cancer, VA recommends you

• Be physically active;
• Maintain a healthy weight;
• Avoid drinking alcohol or limit your intake;
• Discuss risk factors with your doctor regularly; and
• Stay up to date on your breast cancer screening.

Q3. What is the screening process for breast cancer at VA?

A3. Your VA health care team will begin the screening process by assessing your risk of breast cancer. This may include asking you questions about your military service and potential toxic exposures, family and personal medical history, and other risk factors. If they determine a need, you have access to mammograms through VA, where trained professionals conduct an X-ray of your breasts.

For women over 40, mammograms are the best test to look for early signs of breast cancer in individuals who have no signs or symptoms, but who may be at risk. Mammograms can find breast cancer early and decrease the chance of late breast cancer disease and death.

Note that there are risks associated with mammograms. For example, if you are younger than 40 you are more likely to get a false positive result that may require unnecessary follow-up, such as additional mammogram images, biopsies, or even surgery. You should always discuss the possible harms of mammograms with your VA health care team, so that you can make an informed decision regarding your health care.

Q4. What breast cancer resources are available at VA?

A4. Breast cancer support and resources available through VA include:

• Breast cancer screening (including mammograms, ultrasounds, and MRI)
• Breast biopsy and surgery
• Cancer diagnosis and treatment
• Full-service oncology, which is the study and treatment of tumors
• Connection to clinical trials

Q5. Is breast cancer guidance different for transgender individuals?

A5. VA recommends that you should follow the same guidance mentioned in A1 if you’re a

• Transgender woman with risk factors and you have taken hormone therapy for more than five years
• Transgender man who has not had your breasts removed or only had a breast reduction

Note that screening is not recommended for men who do not have breast symptoms.